MEDICARE: BARBARA A. BAHRKE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	1291	WI

General Provider Information

NPI Number	:	1952378630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA A. BAHRKE PA-C

Provider Business Mailing Address
First Line	:	11516 N PORT WASHINGTON RD STE 107
Second Line	:
City	:	MEQUON
State	:	WI
Zip	:	53092-3478
Country	:	US
Telephone Number	:	262-241-5040
Fax Number	:

Provider Business Practice Location Address
First Line	:	1033 N MAYFAIR RD
Second Line	:	SUITE 101
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-3442
Country	:	US
Telephone Number	:	414-454-0600
Fax Number	:	414-454-0971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	09/18/2023

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